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1. All of the following are common uses of biochemical markers, except for:
A. As screening or assessment instruments.
B. In the initial screening setting to support or refute other information that leads to proper diagnosis, assessment, and management.
C. For forensic purposes.
D. In detecting occult use of alcohol and other substance in therapeutic settings where abstinence, rehabilitation, and treatment are being promoted.
2. In an individual whose blood alcohol level is _____ but who is already showing tremulousness, brisk reflexes, tachycardia, diaphoresis, and perhaps a CIWA-Ar score in the moderate or high range, it can be reasonably predicted that the withdrawal will be relatively severe.
A. 100mg percent
B. 200mg percent
C. 300mg percent
D. 400mg percent
3. Gamma-glutamyltransferase elevation automatically means liver damage from alcohol use.
A. True
B. False
4. All of the following may be signs and symptoms of alcohol withdrawal, except for:
A. Restlessness, irritability, anxiety, agitation
B. Increased sensitivity to sound, light, and tactile sensations
C. Hypothermia
D. Delusions, usually of paranoid or persecutory varieties
5. Benzodiazepines remain the medication class of choice for treating alcohol withdrawal.
A. True
B. False
6. Before beginning any tapering regimen, the patient must be fully stabilized; that is, all signs and symptoms of withdrawal must be improved.
A. True
B. False
7. Doses of withdrawal medication are omitted if the patient:
A. Is sleeping soundly
B. Shows signs of oversedation
C. Exhibits marked ataxia
D. Any of the above
8. When managing delirium and/or seizures, all of the following are true, except for:
A. In most cases it is safer to overmedicate than to undertreat and allow DTs to develop.
B. Giving the patient a benzodiazepine should not be delayed by waiting for the return of laboratory studies, transportation problems, or the availability of a hospital bed.
C. Loading doses of IV diazepam or lorazepam are recommended, as are IV thiamine following IV glucose, and multiple vitamins.
D. Patients who have had a single witnessed or suspected alcohol withdrawal seizure should be immediately given a benzodiazepine, preferably with IV administration.
9. Like alcohol and sedative withdrawal, uncomplicated opioid withdrawal can be life-threatening.
A. True
B. False
10. Regulations specify that if a patient has failed two detoxification attempts in a _____ period, he or she must be evaluated for a course of treatment other than methadone.
A. 6-month
B. 12-month
C. 18-month
D. 24-month
11. Regardless of the length of time methadone is maintained, the stabilizing effect cannot reverse the immunologic or endocrinologic defects caused by long-term heroin addiction.
A. True
B. False
12. Which of the following is an advantage of clonidine over methadone in the treatment of opioid withdrawal?
A. Clonidine does not produce opioid intoxication and is not reinforcing.
B. The FDA does not classify clonidine as having abuse potential.
C. No specific licensing is required for the dispensing of this medication.
D. All of the above.
13. Why is it important for opioid detoxification to be concluded without significant patient discomfort?
A. The compassionate goal of preventing unnecessary suffering.
B. The strengthening of the therapeutic alliance between the patient and the clinician.
C. The prevention of patients from leaving treatment prematurely.
D. All of the above.
14. An often overlooked but potentially lethal “medical danger” during stimulant withdrawal is the risk of a profound dysphoria that may include suicidal ideas or attempts.
A. True
B. False
15. The most effective means of treating stimulant withdrawal involves:
A. Establishing a period of abstinence from these agents.
B. Inpatient hospitalization.
C. Medication management.
D. All of the above.
16. It can be assumed that the patient is in inhalant withdrawal when they present with:
A. A history of extensive inhalant usage.
B. A sedative-like withdrawal syndrome.
C. No significant history or laboratory data that supports other substances.
D. All of the above.
17. Nicotine withdrawal is noted by abrupt cessation of nicotine use, or reduction in the amount of nicotine used, followed within 24 hours by 4 or more signs, including any of the following, except for:
A. Insomnia
B. Anxiety
C. Increased heart rate
D. Increased appetite or weight gain
18. Nicotine withdrawal symptoms can masquerade as other psychiatric conditions, especially:
A. Bipolar disorder
B. Anxiety and depression
C. ADHD
D. All of the above
19. Which of the following improved success rates for smoking cessation?
A. The ability of patients to develop problemsolving and coping skills.
B. Gradually decreasing the number of cigarettes smoked over a period of time.
C. Relaxation training.
D. All of the above.
20. Bupropion SR should not be used in patients with:
A. A history of seizures
B. Heavy alcohol use
C. Head trauma
D. Any of the above
21. It must be emphasized that nicotine dependence is a chronic relapsing disorder and that patients often make several attempts at quitting before succeeding.
A. True
B. False
22. The most frequently seen symptoms of THC withdrawal include all of the following, except for:
A. Restlessness and irritability
B. Changes in appetite, usually anorexia
C. Diaphoresis
D. Sleep disturbances
23. Which of the following withdrawal symptoms of abrupt discontinuation of anabolic steroids is most prevalent?
A. Reduced libido
B. Fatigue
C. Depression
D. Restlessness
24. Withdrawal syndromes are more likely to be seen than overdose syndromes with GHB and may require airway and respiratory management.
A. True
B. False
25. For the contemporary drug addict, multiple drug use and addiction that includes alcohol is the rule.
A. True
B. False
26. When detoxifying a patient who has been dependent upon multiple substances, which must be addressed first?
A. Sedative-hypnotics
B. Alcohol
C. Stimulants
D. Opioids
27. All of the following are true with regard to acupuncture, except for:
A. Acupuncture is one of the more widely used alternative therapies within the context of addiction treatment.
B. Acupuncture has been viewed as an effective adjunct to treatment for alcohol and cocaine disorders, and it also has played an important role in opioid treatment.
C. Acupuncture is recommended as a stand-alone treatment for opioid withdrawal.
D. All of the above are true.
28. Ideally, programs detoxifying pregnant women from alcohol and illicit drugs should include which of the following?
A. Detoxification on demand
B. Woman-centered medical services
C. Transportation services to and from detoxification
D. All of the above
29. When pregnant women are detoxified from alcohol, long-acting benzodiazepines are the practice of choice.
A. True
B. False
30. Comprehensive care for the pregnant woman who is opioid dependent must include a combination of all of the following, except:
A. Detoxification
B. Methadone maintenance
C. Prenatal care
D. Substance abuse treatment
31. One of the most important practices that should be in place as a standard in any detoxification setting is routine screening for disabilities and co-occurring medical and/or psychiatric conditions.
A. True
B. False
32. African Americans are more likely to have less of the enzyme activity needed to eliminate _____ than others, so it may have a longer half-life in African Americans than it does in other ethnic groups.
A. Methadone
B. Diazepam
C. Carbamazepine
D. Phenobarbital
33. Urgent attention is needed if the patient is diagnosed with which of the following?
A. Abdominal aortic aneurysm
B. Perforated peptic ulcer
C. Obstructed or strangulated bowel
D. Any of the above
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